A Rare Diagnosis in a Tertiary Institution: First Ever Case Report and Literature Review of Giant Cystadenoma of the Prostate at the University of Benin Teaching Hospital, Benin City, Edo state, Nigeria

Abstract

Background: Giant multilocular cystadenoma of the prostate (GMCP) is an extremely rare Benign tumour of the prostate gland. An extremely high index of suspicion is required to make a clinical diagnosis, however, in most cases, the diagnosis is made following radiologic investigations and histologic examination of resected specimen. We report the first case of GMCP seen at our institution and ever reported in Nigeria.

Case Description: Our patient was a 64-year-old man who presented to our facility, with painless lower abdominal swelling, storage and voiding lower urinary tract symptoms. He had several episodes of acute urinary retention relieved by a urethral catheterisation and had been catheter dependent. Abdominopelvic ultrasound scan (USS), abdominopelvic computed tomography (CT) scan and magnetic resonance imaging (MRI) done revealed a huge cystic pelvic mass of uncertain origin. Prostate specific antigen (PSA) done on several occasions ranged from 27ng/ml- >100ng/ml. He had transrectal ultrasound (TRUS) guided prostate biopsy on 2 different occasions that revealed prostatic hyperplasia with no evidence of malignancy. He had an initial pelvic exploration which revealed a retroperitoneal mass with an abscess cavity. The mass was resected at that time, but reoccurred about 1 year after. He also had transrectal aspiration of the haemorrhagic cysts on 2 occasions due to pain, with cytology revealing haemorrhagic smear and no malignant cells. He subsequently had joint exploratory laparotomy with R2 resection of a huge cystic mass originating from the pelvis and infiltrating the bladder and surrounding abdominal viscera. Histology of the resected mass revealed the diagnosis of GMCP.

Conclusion: With no reported case of GMCP in Nigeria, we present our diagnostic dilemma of GMCP. A consideration should therefore be made for this entity in male patients presenting with huge cystic masses arising from the pelvis.